- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00001212
Drug Therapy in Lupus Nephropathy
Immunosuppressive Drug Therapy in Membranous Lupus Nephropathy
Studies have shown that up to 26% of patients with systemic lupus erythematoses nephritis may suffer from membranous lupus nephropathy. The disease is characterized by high levels of protein in the urine and may eventually lead to kidney failure.
This study will evaluate the effectiveness and toxic effects of immunosuppressive drug therapy in patients with membranous lupus nephropathy over a 12 month period. The major goal of this therapy is to decrease protein losses and ultimately prevent kidney failure.
Patients enrolled in the study will undergo a routine history and physical examination. In addition, several diagnostic tests will be conducted including; chest x-ray ECG, blood and urine laboratory tests.
Patients will be divided and grouped according to the severity of their disease as shown by kidney function. Each group will then randomly be subcategorized by different treatment plans. Each treatment plan will made up of immunosuppressive medications including prednisone, cyclophosphamide, cyclosporin A, and combinations of these drugs. Patients will receive the medications as directed by the study.
The study will last 12 months and require patients to be admitted for two to five days before the study begins and once the study is completed. Patients will be followed as outpatients throughout the 12 month study.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Maryland
-
Bethesda, Maryland, United States, 20892
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
INCLUSION CRITERIA - All patients admitted to the study must satisfy each of the following criteria:
Ability to provide informed consent to all aspects of the study after full information is provided.
SLE as defined by the presence of at least 4 criteria established by the American Rheumatism Association.
Age 12 years or older.
Membranous lupus nephropathy manifested by 2 or more grams per day of proteinuria in the absence of infection or recognized non-lupus renal disease. A renal biopsy must reveal typical membranous lupus nephropathy by light microscopy. Immune deposits must be predominately sub-epithelial and/or intramembranous in location by electron microscopy.
EXCLUSION CRITERIA - Patients with any one of the following conditions will be excluded:
Medication history of:
- cytotoxic drugs or cyclosporin A for more than 2 weeks during the 10 week period prior to study entry.
- cytotoxic drug therapy or cyclosporin A for more than 10 weeks at anytime in the past.
- cytotoxic drug therapy or cyclosporin A during the 30 day period prior to study entry.
- requirement of corticosteroids in doses greater than 20 mg/m(2)/day of prednisone (or equivalent) for control of extrarenal disease at the time of study entry.
Active acute or chronic infection requiring antimicrobial therapy, or serious viral infection (eg. hepatitis, herpes zoster).
Pregnant females, nursing mothers, or females not practicing birth control.
Patients with a single functioning kidney.
Pre-existent malignancy.
Insulin-treated diabetes mellitus.
GFR less than 25 ml/min/1.73m(2) BSA.
Known toxicity to cyclophosphamide.
Positive tests for HIV infection.
Furthermore, patients with any one of the following conditions (related to the use of cyclosporin A) will be excluded from randomization within renal function group 2 (Glomerular filtration rate greater than 66 ml/min/1.73m(2)):
- Renal biopsy revealing global sclerosis of greater than 50 percent of glomeruli, severe tubular atrophy, or severe interstitial fibrosis.
- Persistently abnormal and unexplained liver function abnormalities (defined as elevated transaminases, bilirubin, or alkaline phosphatase twice the upper limit of normal for at least 1 month) or evidence of active viral hepatitis.
- Hypertension difficult to control or uncontrollable with conventional anti-hypertensive regimens.
- Documented coronary artery disease.
- Convulsive disorders.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Time to complete or partial remission of proteinuria.
Time Frame: Within the firs year after starting protocol treatment
|
Within the firs year after starting protocol treatment
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change in glomerular filtration rate
Time Frame: One year
|
One year
|
Adverse Effects
Time Frame: For the duration of extended follow-up starting at the beginning of protocol treatment
|
For the duration of extended follow-up starting at the beginning of protocol treatment
|
Time to relapse of nephritic syndrome
Time Frame: For the duration of extended follow-up starting at the end of the 12-month protocol treatment period
|
For the duration of extended follow-up starting at the end of the 12-month protocol treatment period
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Donadio JV Jr, Burgess JH, Holley KE. Membranous lupus nephropathy: a clinicopathologic study. Medicine (Baltimore). 1977 Nov;56(6):527-36. doi: 10.1097/00005792-197711000-00007.
- Baldwin DS, Lowenstein J, Rothfield NF, Gallo G, McCluskey RT. The clinical course of the proliferative and membranous forms of lupus nephritis. Ann Intern Med. 1970 Dec;73(6):929-42. doi: 10.7326/0003-4819-73-6-929. No abstract available.
- Baldwin DS, Gluck MC, Lowenstein J, Gallo GR. Lupus nephritis. Clinical course as related to morphologic forms and their transitions. Am J Med. 1977 Jan;62(1):12-30. doi: 10.1016/0002-9343(77)90345-x.
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Immune System Diseases
- Autoimmune Diseases
- Kidney Diseases
- Urologic Diseases
- Connective Tissue Diseases
- Lupus Erythematosus, Systemic
- Nephrotic Syndrome
- Nephrosis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Dermatologic Agents
- Antifungal Agents
- Calcineurin Inhibitors
- Cyclophosphamide
- Prednisone
- Cyclosporine
- Cyclosporins
Other Study ID Numbers
- 860204
- 86-DK-0204
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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